The population of cancer patients is growing rapidly due to demographic changes, earlier identification, and increased survival. Cancer treatment is being dehospitalized due to changing patient preferences, high inpatient costs, and the pressure of prospective hospital reimbursement to limit expenditures on high-cost, long-stay patients. Rising prevalence and changes occurring within the health care reimbursement system necessitate that policy makers learn more about the major cancers. The proposed study will build directly upon the Brown University Cancer and Aging Study. Through this study, the health care utilization patterns of a population based cohort of lung, breast, and colorectal cancer patients (N = 1572), identified in Rhode Island, have been documented. Each patient will have been followed for the 2 year period following diagnosis. The proposed study will continue to follow this cohort of patients for 3 additional years yielding a patient database containing health care utilization and cost data for a 5 year post-diagnostic period. Health care utilization data will continue to be collected at 9 of the state's hospitals, all of the state's radiation therapy centers, and most of the state's medical oncology practices. Cost data provide by Blue Cross/Blue Shield and HCFA will be merged with the patient utilization data. Patients participating in the interview phase of the Cancer and Aging Study will continue to be interviewed annually. Interviews will document quality of life and functional status. In addition to examining the medical care epidemiology of patients diagnosed with lung, breast, or colorectal cancer, the proposed study will also determine the influence of health status, family and community resources, and demographic factors on the provision, cost, and location of medical treatments patients receive. The relationship between treatment receipt and health state measures of quality adjusted survival, controlling for age and normal disease-stage specific survival rates will also be examined.